Abstract
Purpose
To report the first occurrence of successful ovarian stimulation, oocyte retrieval and oocyte cryopreservation for fertility preservation in an adolescent with severe sickle cell disease scheduled to undergo a hematopoietic stem cell transplant
Methods
Case report
Results
A 19 year old female with severe sickle cell disease presented for fertility preservation counseling prior to hematopoietic stem cell transplantation. She ultimately underwent ovarian stimulation using a minimal stimulation GnRH antagonist protocol resulting in the successful banking of oocytes prior to transplant. The unique hazards associated with ovarian stimulation in patients with sickle cell disease, such as thrombosis and vaso-occlusive events, are discussed and the methods undertaken to minimize these risks are described.
Conclusions
Controlled ovarian hyperstimulation and oocyte banking for fertility preservation is feasible in young women with sickle cell disease requiring hematopoietic stem cell transplant and deserves further investigation. Given the elevated risk of thrombosis and predisposition to painful vaso-occlusive events, controlled ovarian hyperstimulation in patients with sickle cell disease is not straightforward and requires a multi-disciplinary team approach to adequately address and minimize the risks in this unique patient population.
References
Abboud RM. Hematopoietic stem-cell transplantation for adults with sickle cell disease. N Engl J Med. 2009;361(24):2380–81.
Ohene-Frempong K, Weiner SJ, Sleeper LA, Miller ST, Embury S, Moohr JW, Wethers DL, Pegelow CH, Gill FM. Cerebrovascular accidents in sickle cell disease: rates and risk factors. Blood. 1998;91(1):288–94.
Minter KR, Gladwin MT. Pulmonary complications of sickle cell anemia. A need for increased recognition, treatment, and research. Am J Respir Crit Care Med. 2001;164(11):2016–19.
Platt OS, Brambilla DJ, Rosse WF, Milner PF, Castro O, Steinberg MH, Klug PP. Mortality in sickle cell disease: life expectancy and risk factors for early death. N Engl J Med. 1994;330(23):1639–44.
Walters MC, Hardy K, Edwards S, Adamkiewicz T, Barkovich J, Bernaudin F, Buchanan GR, Bunin N, Dickerhoff R, Giller R, et al. Pulmonary, gonadal and central nervous system status after bone marrow transplantation for sickle cell disease. Biol Blood Marrow Transplant. 2010;16:263–72.
Sklar C. Maintenance of ovarian function and risk of premature menopause related to cancer treatment. J Natl Cancer Inst Monogr. 2005:25–7.
Schimmer AD, Quatermain M, Imrie K, Ali V, McCRae J, Stewart AK, Crump M, Derzko C, Keating A. Ovarian function after autologous bone marrow transplantation. J Clin Oncol. 1998;16:2359–63.
Thibaud E, Rodriguez-Macias K, Trivin C, Esperou H, Michon J, Brauner R. Ovarian function after bone marrow transplantation during childhood. Bone Marrow Transplant. 1998;21:287–90.
Sarafoglou K, Boulad F, Gillio A, Sklar C. Gonadal function after bone marrow transplantation for acute leukemia during childhood. J Pediatr. 1997;130:210–6.
Matsumoto M, Shinohara O, Ishiguro H, et al. Ovarian function after bone marrow transplantation performed before menarche. Arch Dis Child. 1999;80:452–4.
Sanders JE, Hawley J, Levy W, et al. Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation. Blood. 1996;87:3045–52.
Mayer EI, Dopfer RE, Klingebiel T, Scheel-Walter H, Ranke MB, Neithammer D. Longitudinal gonadal function after bone marrow transplantation for acute lymphoblastic leukemia during childhood. Pediatr Translant. 1999;3(1):38–44.
Vlachapapodopoulou E, Kitra V, Peristeri J, Goussetis E, Karachaliou F, Petropoulos D, Fotinou A, Michalacos S, Graphakos S. Gonadal function of young patients with beta-thalassemia following bone marrow transplantation. J Pediatr Endocrinol Metab. 2005;18(5):477–83.
Noyes N, Porcu E, Borini A. Over 900 oocyte cryopreservation babies born with no apparent increase in congenital anomalies. Reprod Biomed Online. 2009;18:769–76.
Ataga KI, Orringer EP. Hypercoagulability in sickle cell disease: a curious paradox. Am J Med. 2003;115:721–28.
Charneski L, Congdon HB. Effects of antiplatelet and anticoagulant medications on the vasoocclusive and thrombotic complications of sickle cell disease: a review of the literature. Am J Health Syst Pharm. 2010;67:895–900.
Smith GD, Serafina PC, Fioravanti J, Yadid I, Coslovsky M, Hassun P, Alegretti JR, Motta EL. Prospective randomized comparison of human oocytes cryopreservation with slow-rate freezing or vitrification. Fertil Steril. 2010;94(6):2088–95.
Shalet SM, Didi M, Ogilvy-Stuart AL, Schulga J, Donaldson MD. Growth and endocrine function after bone marrow transplantation. Clin Endocrinol (Oxf). 1995;42:333–9.
Schubert MA, Sullivan KM, Schubert MM, et al. Gynecological abnormalities following allogeneic bone marrow transplantation. Bone Marrow Transplant. 1990;5:425–30.
Lee SJ, Schover LR, Partridge AH, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006;24:2917–31.
Cobo A, Domingo J, Perez S, Crespo J, Remohi J, Pellicer A. Vitrification: an effective new approach to oocyte banking and preserving fertility in cancer patients. Clin Transl Oncol. 2008;10:268–73.
Oktay K, Cil AP, Bang H. Efficiency of oocyte cryopreservation: a meta-analysis. Fertil Steril. 2006;86:70–80.
Practice Committee of the American Society of Reproductive Medicine. Ovarian tissue and oocyte cryopreservation. Fertil Steril. 2008;90:S241–246.
Donnez J, Silbers S, Andersen CY, Demeestere I, Piver P, Meirow D, Pellicer A, Dolmans MM. Children born after autotransplantation of cryopreserved ovarian tissue: a review of 13 live births. Ann Intern Med. 2011;43:437–50.
Roux C, Amiot C, Agnani G, Aubard Y, Rohrlich PS, Piver P. Live birth after ovarian tissue autograft in a patient with sickle cell disease treated by allogeneic bone marrow transplantation. Fertil Steril. 2010;93(7):2413.e15–9.
Kirkpatrick MB, Haynes J. Sickle cell disease and the pulmonary circulation. Semin Respir Crit Care Med. 1994;15:473–81.
Ataga KI. Hypercoagulability and thrombotic complications in hemolytic anemia. Hematologica. 2009;94(11):1481–84.
Villers MS, Jamison MG, DeCastro LM, James AH. Morbidity associated with sickle cell disease in pregnancy. Am J Obste Gynecol. 2008;199:125.e1–5.
American College of Obstetricians and Gynecologists Practice Bulletin. Use of hormonal contraception in women with coexisting medical conditions. ACOG Practice Bulletin No 73; 2006:1–20.
Chan WS, Dixon ME. The “ART” of thromboembolism: a review of assisted reproductive technology and thromboembolic complications. Thromb Res. 2008;121:713–26.
Stewart JA, Hamilton PJ, Murdoch AP. Thromboembolic disease associated with ovarian stimulation and assisted conception techniques. Hum Reprod. 1997;12(10):2167–73.
Vloeberghs V, Peeraer K, Pexsters A, D’Hooghe T. Ovarian hyperstimulation syndrome and complications of ART. Best Pract Res Clin Obstet Gynaecol. 2009;23:691–709.
Kol S, Itskovitz-Eldor J. Gonadotropin-releasing hormone agonist trigger: the way to eliminate ovarian hyperstimulation syndrome—a 20 year experience. Semin Reprod Med. 2010;28(6):500–5.
Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C. The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective, randomized controlled study. Fertil Steril. 2008;89(1):84–91.
Stuart MJ, Nagel R. Sickle-cell disease. Lancet. 2004;364:1343–60.
National Institute of Health, National Heart, Lung and Blood Institute, Division of Blood Diseases and Resources. The management of sickle cell disease. NIH Publication No 02-2117, 4th edition, 2002: 1–188
Ballas SK. Sickle cell anaemia: progress in pathogenesis and treatment. Drugs. 2002;62(8):1143–72.
Benjamin LJ, Dampier CD, Jacox AK et al. Guidelines for the management of acute and chronic pain in sickle cell disease. APS clinical practice guideline series no 1. Glenview, IL, 1999.
Morrissey LK, O’Brian Shea J, Kalish LA, Weiner DL, Branowicki P, Heeney MW. Clinical practice guideline improves the treatment of sickle cell disease vasoocclusive pain. Pediatr Blood Cancer. 2009;52:369–72.
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Capsule Successful ovarian stimulation, vaginal egg retrieval, and oocyte cryopreservation in a patient with severe sickle cell disease was performed for fertility preservation prior to hematopoietic stem cell transplantation, and the interventions taken to minimize the risks of ovarian stimulation in this patient with significant medical comorbidities are described.
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Dovey, S., Krishnamurti, L., Sanfilippo, J. et al. Oocyte cryopreservation in a patient with sickle cell disease prior to hematopoietic stem cell transplantation: first report. J Assist Reprod Genet 29, 265–269 (2012). https://doi.org/10.1007/s10815-011-9698-2
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DOI: https://doi.org/10.1007/s10815-011-9698-2